The Willows Care Home

Willows Care Home was providing personal care to 11 people aged 65 and over at the time of the inspection. The service can support up to 17 people in one adapted building.

People’s experience of using this service and what we found

Recruitment of new staff was not consistently robust. The provider took action to address these shortfalls. The provider’s systems for recruitment processes and environmental checks was not robust in identifying whether they were in line with current standards.

People told us they felt safe and supported by staff. Staff recognised different types of abuse and how to report it. The provider understood their safeguarding responsibilities and how to protect people from abuse. The provider had mitigated risk of harm and reported incidents to the local authority as required.

Potential risks to people's health and wellbeing had been identified and were managed safely. People, and where appropriate, their relatives, had been involved with decisions in how to reduce risk associated with people’s care. There were enough staff on duty to keep people safe and meet their needs. People's medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.

The manager was visible within the home and listened to people and staff views about the way the service was run. The provider had put checks into place to monitor the quality of the service provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (18 January 2022).

We carried out an unannounced inspection of this service in January 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to ensure safe care and treatment at all times, and to improve how they had sufficient staff to meet people’s needs, and to improve their governance systems.

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Willows Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to recruitment of new staff and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Willows Care Home was providing personal care to 16 people aged 65 and over at the time of the inspection. The service can support up to 17 people in one adapted building.

People’s experience of using this service and what we found

People told us they felt safe and supported by the staff who worked in the home. However, potential risks to people's health and wellbeing had not consistently been identified and were not always managed safely. There was not always sufficient mix of staff on duty. It was recognised that staff should prioritise care to people, however as the provider had been unable to recruit staff into the vacant positions and this had continued for some time. This had impacted on other aspects of the running of the home, such as support to maintain people’s interests and hobbies, managerial work and record keeping. People's medicines were managed in a safe way, however safe storage of medicines needed improving. Safe practice was not consistently carried out to reduce the risk of infection.

The provider did not have checks in place to monitor the quality of the service provision. Staff were not always fully supported or trained to receive the most up to date information for people’s care and social needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update - The last rating for this service was requires improvement (18 January 2022)

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to staffing and staff training. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Willows Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to people’s safety and the leadership of the service.

Full information about CQC’s regulatory response to the more serious concerns can be found at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Willows Care Home was providing personal care to 11 people aged 65 and over at the time of the inspection. The service can support up to 17 people.

People’s experience of using this service and what we found

People were protected from harm by staff that had received training on keeping people safe. Staff understood the risks to people’s health which were recorded in care plans for staff to refer to. Care staff at the home undertook care responsibilities in addition to cleaning, cooking and activities tasks. The care home did not have a dedicated cook, cleaner or activities co-ordinator. This meant the care people received kept them safe but staff did not always have time to deliver support other than task focussed care.

People and their families felt the Registered Manager was easy to engage with and were happy with the support they received. However, checks to review people’s care and recruitment were not always complete or robust.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Good (published 12 April 2016).

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Willows Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

The home operated a booking system when open for visitors and limited visits to one per day. The garden was used when the weather was more favourable and a large indoor room which allowed space to socially distance.

Prominent signage was displayed throughout the home as a reminder for staff and visitors on practices to promote good infection control including wearing Personal Protective Equipment (PPE) and hand washing.

An isolation zone and staff changing room had been identified for use in the event of future outbreaks.

The Willows is registered to provide accommodation and personal care for up to a maximum of 17 people some of who may be living with dementia. At the time of our inspection there were 15 people living at the home.

What life is like for people using this service:

People received safe care and support as the staff team had been trained to recognise signs of abuse or risk and understood what to do to safely support people. People received safe support with their medicines by trained and competent staff members. The provider had systems in place to respond to any medicine errors. Staff members followed effective infection prevention and control procedures. When risks to people’s health and welfare were identified, the provider acted to minimise the likelihood of occurrence.

The provider supported staff in providing effective care for people through person-centred care planning, training and supervision. People were promptly referred to additional healthcare services when required. People were supported to maintain a healthy diet which catered for personal tastes and needs. The environment where people lived suited their individual needs and preferences.

People received help and support from a kind and compassionate staff team with whom they had positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability.

People participated in a range of activities that met their individual choices and preferences and that they found interesting and stimulating. People were provided with information in a way that they could understand. Policies and guidelines important to people were provided in way format that people could access. The provider had systems in place to encourage and respond to any complaints or compliments from people or visitors.

The provider had effective systems to monitor the quality of the service they provided and to drive improvements where needed. The provider and management team had good links with the local community which people benefited from.

More information in Detailed Findings below.

Why we inspected:

This was a planned inspection as part of our published inspection programme.

Follow up:

We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.